Ryan Wagner from Sweden’s Umea University, who conducted his doctoral dissertation on epilepsy treatment in rural Agincourt, South Africa, found that patient education and healthcare monitoring by community health workers in poor areas might help reduce the epilepsy treatment gap that exists in sub-developed countries.
Epilepsy, a chronic neurological condition characterized by recurrent seizures, can be easily and affordably treated with inexpensive daily medication that costs as little as $5 per year. The disease affects approximately 50 million people worldwide, according to the World Health Organization.
Estimates indicate that the population with active epilepsy is between 4 and 10 per 1,000 people. However, some studies in low- and middle-income countries suggest that this proportion is much higher, between 7 and 14 per 1,000 people.
WHO reports that in sub-developed countries, about three-fourths of people with epilepsy may not receive the appropriate treatment, an unfortunate situation that has been deemed “the treatment gap.”
In an effort to overcome this reality, the WHO Program on Reducing the Epilepsy Treatment Gap and the mhGAP Mental Health Action Program are focusing efforts on low-income countries such as Ghana, Mozambique, Myanmar, and Vietnam. The main objectives include reducing the treatment gap and morbidity of people with epilepsy, training health professionals, reducing the stigma associated with the disease, and identifying potential prevention and disease control strategies.
Wagner, the author of the dissertation, is a researcher at the Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health. He followed several individuals in rural Agincourt, South Africa, including epilepsy patients and non-epileptic patients registered in the Agincourt Health and Demographic Surveillance System. Through blood tests, researchers determined those who had epilepsy and which of these patients were not adequately receiving or taking treatment.
Wagner and his colleagues determined that 63 percent of these patients were not receiving appropriate care and were in urgent need of treatment. As a solution, the researchers determined that employing local community health workers to advise and educate patients and monitor their adherence to medication for epilepsy would be a cost-effective intervention to reduce the treatment gap. Reducing this gap can result in less of a burden from the disease, which leads to improved productivity and fewer costs with emergency care.
“Using sound epidemiology and population-based research sites, such as Agincourt, disease parameters can be measured and interventions modeled to determine their cost-effectiveness. Continued epilepsy research is essential in order to reduce the treatment gap for some of the world’s most vulnerable populations,” Wagner said in a news release.